What Will Social Anxiety Therapy Be Like in 100 Years?

Future mental health treatment could have a different focus.
The future of therapy for social anxiety could look very different. Getty / Paper Boat Creative

Have you ever wondered what therapy of the future might look like? When it comes to social anxiety disorder (SAD), I would imagine there may be a number of advancements with respect to therapy of the future.

Below are my "musings" as to what that therapy might look like and how it may morph from the beginning of some current avenues of treatment.

Virtual Reality Therapy

Drexel University in Philadelphia has pioneered treatment of social anxiety disorder using online virtual environments in the program "Second Life." It is easy to imagine that therapy of the future could be centered around the use of virtual reality to practice exposure to social and performance situations for those with social anxiety.

Such therapy would be cost-effective, easy to implement, and a good first step for those still too anxious to engage in real-world exposures. One hundred years from now, it could even be as simple as signing up for your virtual reality exposure session online, popping on your special glasses, and engaging in a therapy session right in your own home.


People with social anxiety have a tendency to avoid others—a tendency that can be "trained" away. Could the future of social anxiety therapy be centered around computer programs that reprogram your brain to move toward social interaction rather than away from it? I have a hunch that we are going to see more of these pre-programmed types of interventions that will be useful in conjunction with more traditional forms of talk therapy such as cognitive-behavioral therapy (CBT).

Cognitive Bias Modification

In a similar vein to approach-avoidance, there is an interesting line of research into SAD treatment related to the tendency of individuals with social anxiety to pay attention to negative feedback in the environment rather than positive feedback.

For example, the person with SAD giving a speech might be focused on that one audience member with a frown on his face.

I can easily see cognitive bias modification (CBM) playing a role in future therapy of SAD. This type of program involves training those with social anxiety to pay more attention to positive rather than negative feedback (and specifically facial expressions of others).

This is kind of like CBT, but done in at a level that is not conscious to the participant. I like the idea of a future treatment for SAD that involves less "thinking about thinking." We all know that people with the disorder already think enough!

Paying it Forward

Recent research tells us that being kind to others can help to reduce social anxiety. Based on this research, I can imagine future treatments that are focused "away" from the problem rather than "toward" it. Although this might seem counter-intuitive (how can you fix the problem if you ignore it), it is not that different from the premise of mindfulness and acceptance-based treatment for SAD, which is just starting to take root. The idea is that if you stop struggling against your anxiety, identify your life values, and act in accordance with them while acknowledging your feelings, then your anxiety will lessen.

These are just a few ideas about what therapy might look like for social anxiety 100 years from now. I am quite sure that there will be many more innovations before then, and it would be fun to brainstorm what those might be. For now, I am content in the knowledge that we are on the cusp of many promising new avenues of research.


Yuen EK, Herbert JD, Forman EM, Goetter EM, Comer R, Bradley J-C. Treatment of Social Anxiety Disorder Using Online Virtual Environments in Second Life. Behavior Therapy 2013;44:51–61. Accessed November 30, 2015.

Rinck M, Telli S, Kampmann IL, Woud ML, Kerstholt M, Velthuis ST, et al. Training approach-avoidance of smiling faces affects emotional vulnerability in socially anxious individuals. Frontiers in Human Neuroscience 2013;7:481. Accessed November 30, 2015.

Bias Modification Therapy. Cognitive Bias Modification Can Help Boost Your Mood, Reduce Stress and Break Addiction. Accessed November 30, 2015.

Trew JL, Alden LE. Kindness reduces avoidance goals in socially anxious individuals. Motivation and Emotion 2015: 9499.

Continue Reading